Clinical Efficacy and Mechanism Exploration of Traditional Chinese Medicine Therapy on Elderly Patients with Type 2 Diabetes Mellitus Complicated with Gastrointestinal Autonomic Neuropathy

目的：探讨中医疗法(针灸、中药、推拿等)对老年2型糖尿病胃肠自主神经病变(DAN)患者的症状改善及自主神经功能恢复的临床效果，并探讨其潜在机制。方法：本研究采用便利抽样法，选取2024年3月2025年3月入住延安市吴起县人民医院中医科的老年2型糖尿病合并胃肠自主神经病变患者作为研究对象。对老年糖尿病胃肠DAN患者实施中医治疗方案(分型论治方案)疗程12周。于实施中医疗法前及实施治疗12周后评估患者《糖尿病胃肠病中医证候评分表》得分、抑郁量表(SDS)得分、匹兹堡睡眠质量指数(PSQI)得分及其糖化血红蛋白值。中医疗法治疗前后胃肠自主神经病变患者组间比较采用配对样本t检验，不同分型治疗效果比较采用χ2检验，以P P P Objective: To investigate the clinical effect of traditional Chinese medicine rehabilitation therapy (acupuncture, Chinese medicine, massage, etc.) on the improvement of symptoms and the recovery of autonomic nervous function in elderly patients with type 2 diabetes gastrointestinal autonomic neuropathy (DAN), and to explore its potential mechanism. Methods: Convenience sampling method was used to select elderly patients with type 2 diabetes combined with gastrointestinal autonomic neuropathy who were admitted to the Department of Traditional Chinese Medicine of Wuqi County People’s Hospital of Yan’an City from March 2024 to March 2025 as the study objects. The elderly diabetic gastrointestinal DAN patients were treated with traditional Chinese medicine rehabilitation program (type based treatment program) for 12 weeks. The scores of TCM Syndrome Scale, Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI) and HBA1c were evaluated before and after 12 weeks of TCM rehabilitation therapy. Paired sample t test was used to compare gastrointestinal autonomic neuropathy patients before and after TCM rehabilitation treatment, and c2 test was used to compare the therapeutic effects of different types, with P P P < 0.05). Conclusion: In this study, the clinical efficacy of traditional Chinese medicine rehabilitation treatment for elderly type 2 diabetes patients with gastrointestinal autonomic neuropathy is safe and effective. The clinical effect of this treatment program is more obvious for patients with cold and heat disorder, spleen-kidney Yang deficiency combined with dampness stagnation, and Qi-yin deficiency combined with intestinal dryness, while it has no obvious clinical effect for patients with gastropalsy type qi stagnation and blood stasis. Traditional Chinese medicine rehabilitation therapy can effectively improve the gastrointestinal symptoms of diabetic gastrointestinal DAN patients, improve their psychological status, improve their sleep quality, and reduce the overall blood sugar level in the past 8~12 weeks. The mechanism may be related to improving gastrointestinal symptoms and regulating the recovery of autonomic nervous function.